Provider Demographics
NPI:1225170756
Name:TERNES, JOSEPH W (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:W
Last Name:TERNES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5829 KENNETT PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19807-1124
Mailing Address - Country:US
Mailing Address - Phone:302-655-7461
Mailing Address - Fax:302-655-1954
Practice Address - Street 1:5829 KENNETT PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19807-1124
Practice Address - Country:US
Practice Address - Phone:302-655-7461
Practice Address - Fax:302-655-1954
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000610103T00000X
PAPS006478L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE491040Medicare PIN
PATE563139Medicare ID - Type UnspecifiedEXACTA MEDICARE